title: [A case of cavernous sinus aspergillosis].
abstract: We reported a case of cavernous sinus aspergillosis. A 62-year-old man complained of trigeminal neuralgia in the right V1 region. Neurological examination on admission showed ptosis, loss of light reflex and ophthalmoplegia externa in the right side. MRI enhanced with gadolinium demonstrated sphenoid sinusitis and mass lesion in the right cavernous sinus. MRA revealed right internal carotid artery occlusion. An open biopsy using the extradural temporopolar approach was performed. Pus discharge was observed from the cavernous sinus and histological examination showed hypha of Aspergillus. With early voriconazole treatment, the patient had improvement in headache, ptosis and ophthalmoplegia externa. Cavernous sinus aspergillosis is often found after sphenoiditis. It results in invasion to an internal carotid artery and worsens the patient's prognosis by cerebral infarction, so early diagnosis and treatment are important. We should consider aspergillosis as one of the differential diagnoses of a mass in the cavernous sinus. The epidural approach to this lesion was available to obviate aspergillus dissemination into the medullary cavity.
authors.affiliation: Department of Neurosurgery, International University of Health and Welfare Hospital.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Hase
authors.forename: Hideharu
authors.initials: H
authors.lastname: Kurita
authors.forename: Eiji
authors.initials: E
authors.lastname: Matsumoto
authors.forename: Hajime
authors.initials: H
authors.lastname: Kuroda
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hashimoto
authors.forename: Souji
authors.initials: S
authors.lastname: Shinoda
mesh_terms: D001228:Aspergillosis / Q000150:complications / Q000473:pathology / Q000601:surgery*; D002426:Cavernous Sinus / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods; D009886:Ophthalmoplegia / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D015524:Sphenoid Sinusitis / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome